This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Stroke is a pervasive and potentially debilitating disease that affects about 5 million Americans (American Heart Association) and is the leading cause of permanent long term disability in the U.S. It is estimated that there are approximately 700,000 strokes in the U.S. each year. More than half of all stroke survivors experience some form of neuromotor impairment. The most common symptom after stroke is hemiparesis, a gross motor impairment that most often is unilateral. In particular, many stroke survivors are unable to use their arms and hands in a functional manner to complete activities of daily living such as feeding, grooming, dressing, toileting, bathing, and writing. These motor impairments impede their ability to lead productive and independent lives.